西藏、新疆及广东白内障患者眼生物学参数的比较

Normative data of ocular biometry in cataract patients from Tibet, Xinjiang and Guangdong

目的建立西藏、新疆及广东3个区域白内障患者的物学参数的参考值范围，并分析比较不同地区白内障患者眼轴及角膜相关的生物学参数．为不同地区的白内障患者的治疗提供参考数据。方法横断面研究。收集2007—2008年健康快车在西藏、新疆及广东地区实施白内障手术的50岁以上患者1944例，其中西藏患者249例，新疆患者615例，广东患者1080例。对每例患者选择1眼用A超测量眼轴长度（AL）、前房深度（ACD）、晶状体厚度（LT）、玻璃体腔深度（VH），自动验光仪测量水平角膜曲率（HK）、水平角膜曲率半径（HR）、垂直角膜曲率（VK）、垂直角膜曲率半径（VR）。比较三地白内障患者的眼生物学参数的差异，建立三地的眼生物学参数参考值范围。采用多元方差分析或HotellingT2检验分析数据。结果西藏、新疆、广东地区女性的AL分别为（22．52±0．79）mm，（22．63±0．68）mm和（22．80±0．84）mm，ACD分别为（2．63±0．43）mm，（2．81±0．42）mm和（2．74±0．41）mm，LT分别为（3．95±0．45）mm，（4．16±0．54）mm和（4．11±0．52）mm。三地男性的AL分别为（22．97±0．80）mm，（23．19±0．70）mm和（23．23±0．77）mm，ACD分别为（2．81±0．49）mm，（2．95±0．43）mm和（2．78±0．44）mm，LT分别为（3．98±0．48）mm，（4．19±0．54）mm和（4．22±0．55）mm。三地的AL（男性F=4．781，P〈0．01；女性F=7．324，P〈0．01），ACD（男性F=8．914，P〈0．01；女性F=5．903．P〈0．01）和LT（男性F=8．835，P〈0．01；女性F=8．446，P〈0．01）比较差异均有统计学意义。其中广东及新疆地区男性患者的AL和LT值均较西藏大（P均〈0．05），而西藏及广东地区的ACD较新疆浅（P均〈0．05）。在女性患者方面，西藏及新疆地区的AL均较广东短（尸均〈o．05），广东及新疆的ACD及LT值均较西藏大（P均〈0．05）。角膜曲率广东大于西藏，西藏大于新疆（P均〈0．05）。结论本研究建立了西藏、新疆及广东3个地区白内障患者的生物学参数的参考值范围，3个地区的眼生物学参数分性别比较存在区别。

Objective To compare the ocular biometry and build up the normative database in cataract patients older than 50 years from Tibet, Xinjiang and Guangdong. To provide reference data for cataract patient in different areas. Methods This study nonrandomly selected one thousand nine hundred ninty four eyes from 1 994 subjects aged 〉50 years. Subjects from Tibet, Xinjiang and Guangdong were 249, 615 and 1 080 respectively. All subjects received cataract surgeries on Lifeline Express from 2007 to 2008. A-scan ultrasound and auto keratometer were used to measure axial length （AL）, anterior chamber depth （ACD）, lens thickness （LT）, vitreous cavity depth （VH）, vertical and horizontal keratometry, vertical and horizontal radius of corneal curvature. Normative data of all measured ocular biometry were determined and compared for the three areas. ANOVA and Hotelling 12 test was used for data analysis. Results For female subjects form Tibet, Xinjiang and Guangdong, the mean AL were 22.52±0.79 mm, 22.63±0.68 mm and 22,80±0.84 ram, the mean ACD were 2.63±0.43 mm, 2.81±0.42 mm and 2.74±0.41 mm, the mean LT were 3.95±0.45 ram, 4.16±0.54 mm and 4.11±0.52 mm respectively. For male subjects, the mean AL were 22.97±0.80 mm,23.19±0.70 mm and 23.23±0.77 mm, the mean ACD were 2.81±0.49 ram, 2.95±0.43 mm and 2.78± 0.44 mm, the mean LT were 3.98±0.48 mm, 4.19±0.54 mm and 4.22±0.55 mm respectively. Significant difference was found for AL （male F=4.781, P〈0.01, female F=7.324, P〈0.01 ）, LT （male F=8.835, P〈0.01, female F=8.446, P〈0.01） and ACD （male F=8.914, P〈0.01, female F=5.903, P〈 0.01 ） among three areas. For male patients, AL and LT of Guangdong and Xinjiang were larger than Tibet （all P〈0.05）. ACD of Tibet and Guangdong was larger than Xinjiang （all P〈0.05）. For female patients, AL of Tibet and Xinjiang was smaller than Guangdong （all P〈0.05）. ACD and LT of Guangdong and Xinjiang were larger than Tibet （all P〈0.05）. Keratometry was largest in Guangdong and smallest in Xinjiang （all P〈0.05）. Conclusion This study built up the normative database of ocular biometry in three areas and found biometry was different with sex and areas. Ocular biometry is different among areas with different races and environmental factors. Cautions should be exercise in clinical practice in these areas.